Provider Demographics
NPI:1316566631
Name:EMAMI, ALEX ALIREZA (MD)
Entity Type:Individual
Prefix:
First Name:ALEX
Middle Name:ALIREZA
Last Name:EMAMI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:SEYED
Other - Middle Name:ALIREZA
Other - Last Name:EMAMI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:20 HARRINGTON RD
Mailing Address - Street 2:
Mailing Address - City:FRAMINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01701-2642
Mailing Address - Country:US
Mailing Address - Phone:917-951-8086
Mailing Address - Fax:
Practice Address - Street 1:139 WINTER ST
Practice Address - Street 2:
Practice Address - City:TILTON
Practice Address - State:NH
Practice Address - Zip Code:03276-5415
Practice Address - Country:US
Practice Address - Phone:248-660-1220
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-16
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NH22114207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program